What are Inflammatory Ear Polyps?
Inflammatory polyps are benign growths that originate in the middle ear canal of young to middle aged cats. The exact reason for their development is not clear, but seems to be related to chronic inflammation/infection within the middle ear. As the polyps enlarge, they either break through the ear drum into the ear canal causing irritation and infection or travel down the Eustachian tube into the pharyngeal area (back of the throat) causing difficulty breathing and/or swallowing. In some cases, a polyp will grow in both directions simultaneously (into the ear canal and throat). Polyps usually occur in one ear, but it is not uncommon to identify them in both middle ears at the same time.
Diagnosis
Cats typically present to the veterinarian for an ear infection or making “funny noises” while breathing. A presumptive diagnosis is made by visual identification of a grayish mass within the ear canal or at the back of the throat. A definitive diagnosis is made by a pathologist after complete polyp removal or biopsy. Skull x-rays are often taken prior to surgery to evaluate the inside of the osseous bullae (middle ears) for signs of disease.
Treatment
The treatment of choice is a ventral bulla osteotomy, where the bottom of the bulla (middle ear) is surgically opened allowing for complete removal of the “root” of the polyp to prevent recurrence. If a polyp is removed from the ear canal or throat without removing its “root” from within the middle ear, the majority will recur within 6 months. The ventral bulla osteotomy can also be performed to remove infected debris from and provide temporary drainage (1-5 days) of the middle ear in cases of chronic otitis media (middle ear infection) where the ear canal is relatively normal. Patients are given antibiotics for 2-4 weeks post-op based on bacterial culture and sensitivity results (identification of a specific bacteria and what kills it). Complications are few but include Horner’s syndrome (one pupil is larger than the other), head tilt (vertigo-like feeling), ongoing middle ear infection, and recurrence of the polyp.